1. Technical Field
The present disclosure relates to surgical procedures and, more particularly, to methods for the placement of sutures in tissue.
2. Discussion of Related Art
Various types of surgical procedures are performed to investigate, diagnose, and treat diseases and conditions within patients. Procedures include, for example, the placement of sutures to close surgical access sites or other wounds or joining tissues.
This patent application claims priority to, and the benefit of, U.S. Provisional Application Ser. No. 61/075,406 filed on Jun. 25, 2008, entitled “Re-Directional Stay Suture Technique for Endoluminal Closure”, the disclosure of which is herein incorporated by reference in its entirety.
Surgical suturing methods may involve the mechanical movement of a device to drive a suture needle into and/or through tissue. A variety of devices have been developed to allow surgeons to perform suturing techniques in open surgery and minimally invasive surgical procedures and to reduce the amount of time needed for placement of stitches and knot tying. Minimally invasive procedures, such as endoscopic or laparoscopic treatment procedures, are often performed by grasping a suture needle with a needle grasping tool and manipulating the tool to place the suture stitches.
Surgery is evolving beyond current flexible endoscopic and laparoscopic approaches. Natural Orifice Transluminal Endoscopic Surgery (NOTES) represents a new phase of minimally invasive surgery. A goal of NOTES is to avoid the trauma of cutting through the heavily muscled abdominal wall. NOTES involves accessing the abdominal cavity via one of the body's natural orifices (mouth, anus, vagina or urethra). A flexible endoscope is advanced into the peritoneal cavity after puncturing one of the viscera (stomach, colon, vagina or bladder), and the operation is performed using conventional endoscopic instruments. NOTES may offer the benefits of a decreased neurohumoral stress response, decreased immunosuppression, decreased postoperative pain, shorter hospital stay, faster recovery, and a decreased incidence of wound-related and pulmonary complications, and it leaves no visible scars. In addition, the elimination of all abdominal wall incisions may eliminate the risk of wound infection and the incidence of incisional hernia.
Challenges to the advancement and clinical acceptance of NOTES include the need for secure enterotomy closure. Although NOTES appears to offer patient benefits, and may establish itself as a viable alternative to open and laparoscopic surgery for the treatment of many gastrointestinal and abdominal conditions, issues remain. An issue raised by the action of purposely puncturing one of the viscera is how to achieve reliable closure. For safe use of NOTES, there is a need for a closure technique that provides a secure closure of the enterotomy site. A need thus exists for a secure, full-thickness closure technique for closing a defect by endoscopic means.
There is a need for methods for the placement of sutures in tissue to close surgical access sites or join tissues in open surgery, minimally invasive surgical procedures, and the like.